Summer House

They don’t know each other, but they have much in common:

They’re both from small towns — Masure from St. Johnsbury, Vt., Payne from Hanover, Va. They used to steal beers from their dads before branching out into a variety of drugs.

They have been "clean" for three years, thanks in part to several 12-step program meetings each week. And they’re both preaching what they practice by working for organizations that offer support to people and families struggling with addiction.

Their stories touch upon themes made clear recently by scientists searching for answers about the genesis and treatment of addiction. The questions have plagued researchers for decades, but only in the past several years have they had the tools — such as technology that provides a real-time view of brain function — to unravel them.

The 2004 National Survey on Drug Use and Health found that of Americans 12 and older, nearly 8.4 million were addicted to alcohol and nearly 5 million were addicted to other drugs. About 1.4 million were addicted to both, according to the survey by the federal Substance Abuse and Mental Health Services Administration.

Thanks to advances in neurobiology, "we have enormous knowledge now of what’s going on" in addicts’ brains, says George Koob, professor of molecular integrative neuroscience at the Scripps Research Institute in La Jolla, Calif. Koob, who calls himself an "irrepressible optimist," says he is hopeful that new insights into the mechanisms of addiction will lead to new treatments and reduced suffering.

They might debate the terms used to describe addiction, but top scientists in the field pretty much agree on what it is.

"The inability to stop is the essence of what addiction is," says Nora Volkow, director of the National Institute of Drug Abuse, part of the National Institutes of Health. As Payne, 27, puts it, "my favorite drug was more and all."

That’s not to say that people who can’t make it through the day without latte grandes or Ghirardelli chocolate are addicts, says Volkow, a self-professed "chocoholic" who has pioneered brain-imaging studies of addiction. Caffeine does activate some of the same brain circuits as the drugs of addiction, but only very mildly, she says. Caffeine can be habit-forming, but Starbucks devotees won’t risk jail time or divorce to feed their habit.

Nor is addiction the same as dependence, although the American Psychiatric Association’s diagnostic manual says it is, says Volkow, who’s pushing to drop that wording. "Addiction is much harder to treat. Everybody given an opiate (such as morphine) will become physically dependent, but not everybody will become an addict."

They don’t know each other, but they have much in common:

They’re both from small towns — Masure from St. Johnsbury, Vt., Payne from Hanover, Va. They used to steal beers from their dads before branching out into a variety of drugs.

They have been "clean" for three years, thanks in part to several 12-step program meetings each week. And they’re both preaching what they practice by working for organizations that offer support to people and families struggling with addiction.

Their stories touch upon themes made clear recently by scientists searching for answers about the genesis and treatment of addiction. The questions have plagued researchers for decades, but only in the past several years have they had the tools — such as technology that provides a real-time view of brain function — to unravel them.

The 2004 National Survey on Drug Use and Health found that of Americans 12 and older, nearly 8.4 million were addicted to alcohol and nearly 5 million were addicted to other drugs. About 1.4 million were addicted to both, according to the survey by the federal Substance Abuse and Mental Health Services Administration.

Thanks to advances in neurobiology, "we have enormous knowledge now of what’s going on" in addicts’ brains, says George Koob, professor of molecular integrative neuroscience at the Scripps Research Institute in La Jolla, Calif. Koob, who calls himself an "irrepressible optimist," says he is hopeful that new insights into the mechanisms of addiction will lead to new treatments and reduced suffering.

USA Today — They might debate the terms used to describe addiction, but top scientists in the field pretty much agree on what it is.

"The inability to stop is the essence of what addiction is," says Nora Volkow, director of the National Institute of Drug Abuse, part of the National Institutes of Health. As Payne, 27, puts it, "my favorite drug was more and all."

That’s not to say that people who can’t make it through the day without latte grandes or Ghirardelli chocolate are addicts, says Volkow, a self-professed "chocoholic" who has pioneered brain-imaging studies of addiction. Caffeine does activate some of the same brain circuits as the drugs of addiction, but only very mildly, she says. Caffeine can be habit-forming, but Starbucks devotees won’t risk jail time or divorce to feed their habit.

Nor is addiction the same as dependence, although the American Psychiatric Association’s diagnostic manual says it is, says Volkow, who’s pushing to drop that wording. "Addiction is much harder to treat. Everybody given an opiate (such as morphine) will become physically dependent, but not everybody will become an addict."

WorldWideAddiction.com — Substance Addiction has been recognized "officially" as a disease for many years now, but there is still a great deal of ignorance on the subject -even amongst the medical profession.

Addicts/alcoholics (people tend to separate the two, but from here on in I will use the term "addict" to cover the broad range of substance abusers) are seen as weak people with no will-power.

Want to know what will-power is?

It is waking up in the morning, so nauseous that you race to the bathroom and don’t know which end to use first! After that initial wake-up purge, you then make your way shivering and shaking into the kitchen and drink an open, flat, warm beer that has a cigarette butt floating in it. Or because you are shaking so much, you drink that warm white wine that has been sitting out all night, through a straw since you can’t hold a glass! You do this, choking back the bile that is rising in your throat, because you know that the only way to begin functioning again on some sort of level is to try and build up the alcohol in your system before you take a seizure.

Do you think drinking methylated spirits at 5am in the morning is an easy thing to do?

I have known many addicts whose veins in their arms and legs are so damaged, that they inject themselves in their eyeballs. Because going without their "hit" is a far worse option.

Addicts have plenty of will-power…….

…it’s just focused in the wrong direction. Recovery teaches them us to refocus energy.

Back to the disease concept. Addiction is classified as a disease because it meets the criteria of all other terminal diseases:

- It has pattern of symptoms which are similar across all types of substance abuse

- It is a chronic condition. It doesn’t go away.

- It is progressive. Addiction only gets worse with continued use, and ends with death.

- The person is subject to relapse. In Australia, 66% of addicts who are lucky to live long enough to make it to detox will eventually die as a direct result of the disease.

- It is treatable. Here’s the good news, while substance addiction is a terminal illness, its progression can be arrested at almost any stage. But if you are seeking treatment, it is of the utmost importance that you gain medical advice. Sudden withdrawal, even from "socially acceptable" drugs such as alcohol, can cause death through seizures and coma.

It is crucial that you consult with a medical practitioner that understands addiction and withdrawal. Some well meaning, but uneducated doctors will prescribe large amounts of unsuitable medications that can lead to cross-addiction. This happened to me at one stage, and made a difficult situation worse. If you are addicted to one drug, the likelihood of becoming addicted to others is extremely high.

Wherever possible, detoxification is best carried out in a detox unit, where there is 24 hour patient care. There are a number of these units around the world, and in some cases (especially in Australia) there is no charge for this care.

When world governments begin to understand that the cost in providing this care free of charge is far outweighed by the benefits to society, we will begin to see an incredible drop in poverty, violence and divorce. The cost in providing this care will also be offset by the decrease in need of other hospitalization. 1 in 3 hospital beds in Australia are taken up by people with conditions that can be directly linked to drug abuse. At best, the world health systems overall are only currently providing band-aid solutions to one of the greatest scourges of mankind.

Are you thinking of getting help for yourself or a loved one?… do it now … for tomorrow may be too late. 

If you had terminal cancer, would you do anything about it? 

Substance addiction is a far worse disease in my opinion -it not only destroys the person, but everyone around them.

To those who helped me all those years ago -doctors, nurses, friends and strangers - even though I may not have been appreciative at the time….. my sincerest thank you. My life means something now.

Addiction is a disease, not just a state of mind.

WorldWideAddiction.com — "The road is long, with many a winding turn………"

Never have truer words been spoken - especially when it comes to substance addiction recovery.

When we first decide to crawl out of the darkness and take our tentative steps in the light of sobriety, it’s an amazing experience. We begin to feel stronger and our reasoning abilities become a lot clearer.

……then the emotional crash, the "honeymoon" period is over.

Perhaps you have experienced this and know what I mean. The "high" of making the decision to clean up and detoxing has gone. You are now back in the community and facing it on it’s terms, learning to cope.

You may be alone, isolated in your pain that "normal" people can never understand. You grieve for your lost "friend", even though that friend was actually your worst enemy. You become irritable, uninterested, depressed -perhaps even suicidal. This can lead to a "bust", a bust you may never recover from -remember, that if we are addicted we cannot control our substance intake. The "just one more time" may seal your fate. And as we all know, there are worse things in life than death -the insanity of addiction. You may not be lucky enough to die the next time.

Many of us have experienced this phase, the "emotional roller coaster". For me, it was as though all the colours of the world were washed away. There was no point to anything, my mind constantly went back to the dark days. I was guilt ridden, self-pitying and unmotivated. I was very hard to be around. While others who knew me congratulated me on my efforts, I saw only failure as I didn’t feel "right". I felt the same way I did at the age of 13 when my hell really began.

There is a reason for this - in a lot of ways, I was still 13. When I began abusing substances, a great deal of my emotional growth stopped, the substance was my coping mechanism. At the age of 24, it began again. There was a steep learning curve ahead.

But don’t worry, this phase does not last forever. For me it was one year. For you it may be a few weeks. It depends greatly on your network of support and more so, yourself.

-If you are experiencing this, it is imperative that you build a network of people around you that understand what you are feeling. These people are the recovered addicts. They will know when to hug you and tell you that everything will be OK, and they also know when to kick your butt and tell you to "get over it"….tough love, but necessary.

-If the environment you are in threatens your sobriety, leave it. I am serious…whatever it takes, get the hell out of there! You may be saying to yourself "I can’t leave, I can’t afford to" or "People are relying on me to be around". It doesn’t matter - remember where you have just come from. If you finish up back there again, you may never re-emerge.

-You may have friends who are still practising addicts/alcoholics. Stay away from them if they do not respect what you are doing to improve yourself. It is in the nature of people who have the disease of addiction and are still practising to influence you in subtle ways. In a great deal of cases, it is not on purpose, but more a subconscious thing.

-Start putting routine into your day. I’m not suggesting too much, too soon but keeping busy is a great way of keeping your mind off things. As you become more productive, your self-esteem increases.

-Re-establish a sleeping pattern. Your body has been through hell and back. It needs rest, and your brain needs to sort things out on many levels. Be prepared for nightmares involving the past and use of the substance. Even though you may have no apparent cravings, your subconscious yearns for another hit and expresses this in your dreams. The nightmares are alarming at first. There were many times that I woke up in a pool of sweat. Even seven years down the track I still have them, but I accept them for what they are.

-Eat regular meals. I am a fine example of a toxic waste dump when it comes to things of a dietary nature, but I learnt early in my recovery that cravings could be lessened through eating something. The advice given to cigarette smokers about eating healthily when quitting is sound and good, but it is my experience that when withdrawing from other substances it is wiser to satisfy your food cravings with what it wants, including fatty and sugary foods. Alcoholics will probably find that they will develop a sweet tooth because their bodies are used to high amounts of sugar. So, if you wake up at 3 in the morning and eat a quart of double chocolate chip ice cream smothered in fudge, don’t feel guilty! It’s better that than what you were using before!

-If you find yourself feeling angry a great deal, this is also normal. It is important to examine the anger and not just lash out using whatever situation you are in as a scapegoat. Whatever is going on, it will pass. Breathe deeply and think.

Some of the points above may seem fairly drastic and harsh, but this is a life and death situation. And unlike some other terminal illnesses, addiction destroys everything in it’s path as it destroys you - your family, your friends and anyone you come into prolonged contact with.

The advice above is not mine; it was given to me and I now pass it on to you. The easy way to remember the points is the HALT statement

The 4 Don’ts:

H-ungry
A-ngry
L-onely
T-ired

Good luck to you in your recovery, there are people out there who care about you, even if you don’t know them….

"You alone can do it, but you cannot do it alone"

Drug addiction is a treatable disorder. Through treatment that is tailored to individual needs, patients can learn to control their condition and live normal, productive lives. Like people with diabetes or heart disease, people in treatment for drug addiction learn behavioral changes and often take medications as part of their treatment regimen.

Behavioral therapies can include counseling, psychotherapy, support groups, or family therapy. Treatment medications offer help in suppressing the withdrawal syndrome and drug craving and in blocking the effects of drugs. In addition, studies show that treatment for heroin addiction using methadone at an adequate dosage level combined with behavioral therapy reduces death rates and many health problems associated with heroin abuse.

In general, the more treatment given, the better the results. Many patients require other services as well, such as medical and mental health services and HIV prevention services. Patients who stay in treatment longer than 3 months usually have better outcomes than those who stay less time. Patients who go through medically assisted withdrawal to minimize discomfort but do not receive any further treatment, perform about the same in terms of their drug use as those who were never treated. Over the last 25 years, studies have shown that treatment works to reduce drug intake and crimes committed by drug-dependent people. Researchers also have found that drug abusers who have been through treatment are more likely to have jobs.

Types of Treatment Programs

The ultimate goal of all drug abuse treatment is to enable the patient to achieve lasting abstinence, but the immediate goals are to reduce drug use, improve the patient’s ability to function, and minimize the medical and social complications of drug abuse.

There are several types of drug abuse treatment programs. Short-term methods last less than 6 months and include residential therapy, medication therapy, and drug-free outpatient therapy. Longer term treatment may include, for example, methadone maintenance outpatient treatment for opiate addicts and residential therapeutic community treatment.

In maintenance treatment for heroin addicts, people in treatment are given an oral dose of a synthetic opiate, usually methadone hydrochloride or levo-alpha-acetyl methadol (LAAM), administered at a dosage sufficient to block the effects of heroin and yield a stable, noneuphoric state free from physiological craving for opiates. In this stable state, the patient is able to disengage from drug-seeking and related criminal behavior and, with appropriate counseling and social services, become a productive member of his or her community.

Outpatient drug-free treatment does not include medications and encompasses a wide variety of programs for patients who visit a clinic at regular intervals. Most of the programs involve individual or group counseling. Patients entering these programs are abusers of drugs other than opiates or are opiate abusers for whom maintenance therapy is not recommended, such as those who have stable, well-integrated lives and only brief histories of drug dependence.

Therapeutic communities (TCs) are highly structured programs in which patients stay at a residence, typically for 6 to 12 months. Patients in TCs include those with relatively long histories of drug dependence, involvement in serious criminal activities, and seriously impaired social functioning. The focus of the TC is on the resocialization of the patient to a drug-free, crime-free lifestyle.

Short-term residential programs, often referred to as chemical dependency units, are often based on the "Minnesota Model" of treatment for alcoholism. These programs involve a 3- to 6-week inpatient treatment phase followed by extended outpatient therapy or participation in 12-step self-help groups, such as Narcotics Anonymous or Cocaine Anonymous. Chemical dependency programs for drug abuse arose in the private sector in the mid-1980s with insured alcohol/cocaine abusers as their primary patients. Today, as private provider benefits decline, more programs are extending their services to publicly funded patients.

Methadone maintenance programs are usually more successful at retaining clients with opiate dependence than are therapeutic communities, which in turn are more successful than outpatient programs that provide psychotherapy and counseling. Within various methadone programs, those that provide higher doses of methadone (usually a minimum of 60 mg.) have better retention rates. Also, those that provide other services, such as counseling, therapy, and medical care, along with methadone generally get better results than the programs that provide minimal services.

Drug treatment programs in prisons can succeed in preventing patients’ return to criminal behavior, particularly if they are linked to community-based programs that continue treatment when the client leaves prison. Some of the more successful programs have reduced the rearrest rate by one-fourth to one-half. For example, the "Delaware Model," an ongoing study of comprehensive treatment of drug- addicted prison inmates, shows that prison-based treatment including a therapeutic community setting, a work release therapeutic community, and community-based aftercare reduces the probability of rearrest by 57 percent and reduces the likelihood of returning to drug use by 37 percent.

Drug abuse has a great economic impact on society-an estimated $67 billion per year. This figure includes costs related to crime, medical care, drug abuse treatment, social welfare programs, and time lost from work. Treatment of drug abuse can reduce those costs. Studies have shown that from $4 to $7 are saved for every dollar spent on treatment. It costs approximately $3,600 per month to leave a drug abuser untreated in the community, and incarceration costs approximately $3,300 per month. In contrast, methadone maintenance therapy costs about $290 per month.

A NIDA-funded study has demonstrated that the relapse rate for heroin addicts increases with time and that the probability of long-run abstinence depends on the age of first drug use. Those who start daily heroin use at a younger age are more likely to relapse than those who start later.

The study, conducted by Dr. Marnik G. Dekimpe of the Catholic University Leuven in Belgium and his colleagues in Belgium and at the University of California, Los Angeles, examined the treatment histories of 846 patients at methadone clinics in central and southern California. The researchers looked at males and females, whites and Chicanos, most of whom started using heroin between the ages of 17 and 25. Subjects were interviewed over a 4-year period during and after treatment to determine the probability of their relapse to heroin use.

The finding that relapse is connected to time suggests the need for long-term periodic monitoring of a former heroin user’s abstinence, Dr. Dekimpe says. The researchers also found drug relapse odds were significantly different across the sociodemographic groups studied, suggesting that prevention resources could be directed to groups at higher risk. No significant differences in relapse probability were associated with either gender or education.

Its very simple, substance abuse effects body functioning. Drug use can lead to long term physiological effects that can not only be acutely harmful, but can also result in chronic problems. The use of drugs is not the only issue. It is all the harmful behaviors that come along with substance abuse that tend to make matters worse.
 

Substance abuse harms the body in two distinct ways: via the effect of the substance itself and via negative lifestyle changes, such as irregular eating habits and poor dietary intake. For example, infants who were exposed to alcohol while in the womb often have physical defects and mental disabilities. In this case, the growing fetus has deficits both directly caused by the substance crossing the placenta and indirectly due to inadequate nutrition of the mother while she was drinking.
 

Recovery from substance abuse involves many different components, including proper organ functioning, assuring mental well being and proper metabolism. A huge factor in the healing process is proper nutrient supply. Nutrients are essential for not only for energy, but also to keep the immune system strong which helps to fight off infection and keep one strong.
 

Though it is clear that substance use in general is not healthy, like anything else, different substances have different effects on the body. In this article we will discuss a few of the more popular drug categories and how they each can affect body functioning.

Opiates

Which Drugs Are Opiates?
 

This category includes: codeine, morphine, and heroin. All of these affect the gastrointestinal system. One of the main symptoms associated with opiate use is constipation. When one withdraws from opiates classic symptoms of withdrawal include: diarrhea, vomiting, and nausea. The danger here lies primarily in a depletion of valuable nutrients and electrolytes. This includes imbalance in the amount of potassium, sodium, chloride, and calcium. Electrolytes are important for a variety of things, including proper cardiac, or heart, functioning.
 

To combat the severity of these symptoms, one should eat meals that are balanced (i.e. proper amounts of vegetables, grains, fats, and proteins). A high fiber diet with things such as whole grains, beans, peas and vegetables is advisable due to constipation associated with opiate use.
 

Alcohol
 

Out of all the drugs utilized in the US, alcohol is the major cause of nutritional deficiencies. The most prominent deficiencies include the following:
 

* Pyridoxine or Vitamin B-6
* Thiamine
* Folic Acid
 

An individual lacking in these nutrients may develop anemia which is a low blood count, for women a deficiency in folic acid can cause poor pregnancies, and B vitamin deficiency can also cause neurological problems. Lack of thiamine (B1) in particular, can lead to Korsakoff’s syndrome. It is important to understand that it is not necessarily the alcohol that cause the disorder, but the effect of alcohol of the absorption of nutrients that is damaging.
 

Alcohol damages the liver and pancreas in particular. These two organs are necessary for detoxification and processing (liver) and the pancreas effects blood sugar and absorption of fat. If these two organs are not working properly, one can have an imbalance of fluids, calories and electrolytes.
 

Permanent damage can take place in the form of cirrhosis which is liver damage, diabetes, seizures and malnutrition. Liver damage can also result in decreased clotting factors, which means an individual has the chance of bleeding unnecessarily. Women also have an increased risk for osteoporosis and may require calcium supplementation.
 

Stimulants

What is a stimulant?
 

This includes cocaine, methamphetamine and cocaine. Use of these drugs can lead to a decrease in appetite and weight loss which will eventually lead to malnutrition. As the name implies, stimulants stimulate the body thereby causing many users to stay awake for unhealthy periods of time. This can range from one night of missed sleep, to being awake for days at a time. This may result in dehydration and subsequent electrolyte imbalance. One should return to a normal, balance diet which may be difficult given the abuse the body has suffered especially if there has been severe weight loss.
 

The Marijuana Munchies
 

Marijuana can increase appetite, which, in chronic users can lead to being overweight. For these individuals it is probably best to cut back on sugar, fat and overall caloric intake.
 

Nutrition and psychological aspects of substance abuse
When people feel better, they are less likely to relapse. Since balanced nutrition helps improve mood and health, it is important to encourage an improved diet in people recovering from alcohol and other drug problems. Individuals recovering from substance abuse have just given up a huge part of their life and for this reason, it is better for these individuals to focus on not using again as opposed to putting all their energy into a drastic diet change.

How to Incorporate a Healthy Diet into Recovery
 

Perhaps the most important thing for prior substance abusers to remember is routine. For instance, regular meals throughout the day are recommended. An increase in proteins, complex carbohydrates and dietary fiber are highly recommended. Due to the irregularity of diet that tends to accompany substance abuse, most individuals will needs to supplement diet with vitamins and minerals. As every individual is different, it is recommended that recovering addicts meet with a dietician. A trained professional can then develop a plan that is specific to the person’s needs. The vitamins that are most often lacking include zinc, vitamins A and C and most of the B vitamins.
 

Keeping Your Sugar Steady Can Decrease Cravings
 

As many drug addicts do not eat regularly, they may forget what it feels like to really be hungry. Not eating steadily can cause a fluctuation in blood sugar levels which can lead to feelings of unsteadiness throughout the day. For a recovering addict, these feelings may be interpreted as drug cravings which could lead to one using. This is yet another reason to keep a steady and healthy intake of food.
 

The Importance of Water
 

Dehydration is common for substance users and it is very important to emphasize the need for fluids during and in between meals. As appetite can return during recovery, it is important to emphasize fluid intake as well as proper food consumption. For all the reasons discussed prior, it would be detrimental to recovery for an individual to begin eating the high calorie foods with little to no nutritional value due to all the abuse the body has already endured. Drinking water will help the body to absorb nutrients which is something most of these individuals are lacking.

Substance abuse recovery is a difficult road to follow. Good nutrition is something that can help to make that road a little easier to walk down. Encouraging healthy eating and a healthy lifestyle, is something concerned loved one can do to help ensure the people in their lives stay clean.